Factor V Leiden and Venous Thromboembolism During Pregnancy and the Postpartum Period

Factor V Leiden is a genetic mutation that is associated with increased risk of venous thromboembolism (VTE) and is the most common of the five inherited thrombophilias. VTE is a leading cause of maternal mortality in the United States, mostly due to mortality risk from pulmonary embolism. Factor V Leiden, particularly among homozygotes, figures significantly in the highest risk of VTE during pregnancy and the postpartum period. Current clinical guidelines from professional societies and international bodies often recommend different strategies for stratifying risk and reducing risk of VTE with thromboprophylaxis. This article provides an overview of the role of factor V Leiden and other risk factors for VTE during pregnancy and the postpartum period, approaches to screening and thromboprophylaxis, and practice implications for women's health nurses.